Opinion: The global cost of inaction on malnutrition

Bill Gates once said, “If I had a magic wand that I could wave and cure any disease, let me surprise you … I would pick malnutrition because it destroys so much human potential.”

It’s easy to understand why, because when it comes to nutrition, the status quo is incredibly expensive. For 1 out of every 3 people on the planet, it can lead to weaker immune systems, impaired cognitive and physical development, increased susceptibility to infections, and higher mortality rates. On a broader scale, it undermines economic productivity, perpetuates poverty, bankrupts health systems, and hinders social and economic development.

But these are broad statements. What if we knew with greater precision exactly how much economic damage countries were experiencing every year by not acting on nutrition? Or how many health and human capital outcomes countries could generate for women, children, and adolescents by investing in certain areas? Armed with this knowledge, we could empower decision-makers with the data and analyses they need to understand the consequences of malnutrition on education, gender equality, health, and their economies. This information would help guide policy and investment choices that would prioritize scaling up the most impactful evidence-based nutrition actions. This would save and improve millions of lives, generate momentum for changing the status quo, and accelerate progress toward achieving the Sustainable Development Goals.

Off track to meet the global nutrition targets

In 2012, the World Health Assembly adopted a set of globally agreed time-bound goals intended to inspire ambition and align and guide efforts in nutrition at global, regional, and national levels. These six global nutrition targets cover the reduction of stunting in young children, reducing anemia in women, preventing obesity in children, tackling wasting in children, reducing the incidence of low birth weight in babies, and increasing the rate of breastfeeding in the first six months of life. Despite the overarching importance of nutrition in achieving other SDGs, progress toward these targets has been slow at best, and in some cases, we have lost ground.

Globally, nearly 20 million children are born too small or too soon each year, putting them at a much higher risk of death and disability. Additionally, 148 million children under five are stunted, 245 million suffer from anemia, and more than 586 million adolescent girls and women aged 15-49 are also impacted by anemia. These figures remain high due to poverty, ongoing conflicts, inequality, rising debt burdens, lack of access to quality health care, and more recently the COVID-19 pandemic, which disrupted food systems and health services across the globe. These statistics also underscore our collective lack of focus, urgency, and determination to end one of the biggest sources of preventable suffering on our planet: malnutrition.  

The era of self-congratulatory conferences has long passed. It’s time to acknowledge the harsh reality that our efforts over the past decade simply haven’t been good enough to meet the level of challenge we are facing. Moving forward, we must embrace a greater sense of urgency, commitment, and financing.

In May 2025, WHA member states will convene to approve the extension of the global nutrition targets through 2030. This collective commitment provides the global nutrition community with a renewed sense of direction and a powerful rallying point to seize upon as we transform our rhetoric into action.

“But we’ve had them before!” I hear you say.  That is true — however, in the past, countries have lacked access to the necessary data and analyses to fully understand the consequences of malnutrition on their human capital and health outcomes, as well as their economies. Furthermore, the nutrition community has not been able to systematically quantify the potential economic savings and gains that achieving the global nutrition targets could yield. This information is essential for engaging political leaders and enabling countries to formulate effective policy and investment options. Therefore, if the goals themselves are our destination, the real challenge lies in navigating the fastest and most effective route to get there.

New findings on the cost of inaction on undernutrition

Make no mistake: The slow pace of change on malnutrition comes at a significant cost — one that can be mitigated if we invest in impact and prioritize low-cost, high-impact nutrition actions first. Nutrition International’s new Cost of Inaction Tool allows country-level policymakers and advocates to rapidly generate estimates on the health, human capital, and economic costs of inaction on stunting, low birth weight, and anemia in women and children. Leveraging open-access data, the tool provides a detailed analysis of the costs of allowing limited to no progress on these key indicators.

For instance, the tool reveals that preventable undernutrition, due to stunting, low birth weight, and anemia, cumulatively costs the world at least $761 billion per year, or $2.1 billion per day. It also results in 1.3 million child deaths and 304 million IQ points lost every year. While the underlying data is not new, for the first time it is now available at country-level for over 140 countries around the world. By presenting it in an easy-to-use and comprehensive way, we aim to reinforce policymakers and advocates with invaluable data-driven insights in the fight against malnutrition.

Analyses from the tool indicate that accelerating progress toward the WHA global nutrition targets would deliver a substantial impact. For example, meeting the under-five stunting reduction target of 16.4% would save the global economy $157 billion and avert 369,000 deaths annually. Similarly, by meeting the global target of low birth weight prevalence of 10.5%, the global economy would save $64 billion and nearly 100,000 lives per year. Likewise, meeting the target of anemia in women of reproductive age would save the global economy $60 billion per year. Do better investments exist?

To achieve these goals, we must intensify our focus, energy, and commitment around scaling up proven interventions such as large-scale food fortification, vitamin A supplementation, multiple micronutrient supplementation, and other evidence-based approaches that can transform lives and reach populations at scale. These interventions cost cents per person, yet their impacts last a lifetime. By harnessing data-driven insights, leaders can more clearly determine policy and investment options that drive progress toward national policy objectives.

Mobilizing the global nutrition community to maximize impact

While we may not have a magic wand to end malnutrition, much faster progress is possible. There’s a strong evidence base in nutrition — we know which interventions and approaches work and how much they cost. The key now is ensuring that those who stand to benefit most have access to these solutions. We also know that success requires countries to be both motivated and capable of providing these interventions over the long term.

This upcoming year holds a unique opportunity to rally countries, donors, and civil society partners in building a new trajectory of action for nutrition. In November 2024, key stakeholders will converge at the Scaling Up Nutrition Global Gathering in Rwanda to coordinate efforts on nutrition and set the course for accelerating progress worldwide. Shortly after, in March 2025, the government of France will convene nutrition donors and low- and middle-income country governments at the Nutrition for Growth Summit in Paris, aiming to secure high-level financial and political commitments over the next four years. Following this, WHA member states are poised to review and extend the global nutrition targets through to the SDG deadline of 2030.

If we can capitalize on this unique sequence of events to reinvigorate and refocus the nutrition community’s efforts toward achieving the global nutrition targets, we can pave a clear path to increasing political will, alignment, prioritization, and financing for nutrition. As the world gears up for collective action, we hope that Nutrition International’s Cost of Inaction Tool will prepare and equip players across the nutrition sector with the evidence they need to engage decision-makers and provide a clear rationale for prioritizing interventions and policies that save lives and enhance health and economic outcomes.

We know what inaction on malnutrition is costing us and we can no longer afford the status quo. The lives of millions of people and the hopes of a new generation depend on our ability to accelerate progress. Ending malnutrition won’t be achieved by magic (sadly), but we can move toward that end by remembering our shared commitments and focusing on making the fastest possible progress against our targets.

Nutrition International’s Health Economics unit produces advanced modeling tools and robust data to bolster the organization’s impact in addressing malnutrition. Nutrition International’s Cost of Inaction Tool equips stakeholders with essential evidence for informed decision-making. For further support, including additional analyses, tool demonstrations, and technical assistance in conducting economic analyses, and developing and operationalizing costed nutrition plans and governance frameworks, please contact us at healthecon@nutritionintl.org.